Symptoms of depression are associated with physical inactivity but not modified by gender or the presence of a cardiovascular disease; a cross-sectional study

Abstract

Background Depressive symptomatology may act as a barrier to enhance physical activity. This phenomenon is predominantly found in patients with an established cardiovascular disease (CVD) and in female patients. This cross-sectional study investigated (1) the association between symptoms of depression and physical inactivity, and (2) whether this association is different between primary and secondary prevention patients, and between men and women. Methods The study design concerns a secondary analysis of baseline data from a randomized clinical trial, including primary and secondary prevention patients ( n = 2184; mean age 71.6 ± 8.94), from 34 general practitioner panels. The Rapid Assessment of Physical Activity questionnaire (RAPA) was used to measure patient reported activity levels. Symptoms of depression were determined using the Patient Health Questionnaire (PHQ-9). Multilevel linear regression analysis was used to explore the association between symptoms of depression and physical activity while adjusting for confounders. Gender and whether or not having a CVD were considered as potential effect modifiers for the association between symptoms of depression and inactivity. Results Symptoms of depression were associated with lower levels of physical activity. This association was neither different for men and women nor for primary and secondary prevention patients. Conclusion In primary care patients’ symptoms of depression were associated with physical inactivity. This association was not modified by gender or the presence of a CVD. Future research should focus on lifestyle interventions aiming at the increase of physical activity levels, while emphasizing on improving symptoms of depression in men, women, and patients both with and without a history of CVD.

Association between chronic diseases, multimorbidity and insufficient physical activity among older adults in southern Brazil: a cross-sectional study

“…34 Our results partially agree with those from other studies. 11,32 Achttien et al 11 showed that there was an association between symptoms of depression and lower levels of physical activity, without any difference between men and women (n = 1250; mean age 73.9 ± 6.9 years). In a study without stratification according to sex, Ludwig et al 32 found a positive association between depressive symptoms and insufficient physical activity, regardless of sociodemographic and behavioral factors, or BMI.…”

“…The association between depressive symptoms and insufficient levels of physical activity that was found in the present study is consistent with previous studies showing an inverse relationship between depressive symptoms and physical activity. 11,32 It is known that the association between depressive symptoms and physical activity may be bidirectional. Hence, physical activity is considered to be a healthcare strategy for reducing the risk of developing depression.…”

“…However, depression is a risk factor for reduction of physical activity levels and sedentary behavior. 11 It is believed that the characteristics of depressive symptoms, such as apathy, dysphoria, cognitive impairment and feelings of discomfort make it difficult to practice physical activity, 33 regardless of other comorbidities.…”

“…9,10 Many studies have investigated the association between chronic disease and physical activity among older adults. However, these studies were based on a single-disease model, 11,12 without taking into account adjustments for other diseases, which is the model proposed in the present study.…”

Effect of Study Design and Survey Instrument to Identify the Association Between Depressive Symptoms and Physical Activity in Type 2 Diabetes, 2000-2018: A Systematic Review

“…12 Moreover, a lack of PA is a substantial risk factor for developing depressive symptoms. 13 The literature has suggested that there is a significant relationship between depressive symptoms and physical inactivity 14 and a 2-fold risk of depressive symptoms in inactive people compared to those who engage in regular PA. 15…”